This information applies to England, Scotland and Wales.
For information on claiming Employment and Support Allowance in Northern Ireland, go to the NI Direct website.
What is Employment and Support Allowance (ESA)?
ESA is a benefit for people who have an illness or disability that makes it difficult or impossible for them to work. There are two types of ESA.
Contribution-based ESA: You’ll get this if you’ve made enough National Insurance Contributions.
Income-related ESA: You may get this on its own, or on top of contribution-based ESA, if you are on a low income.
Income-related ESA will eventually be replaced by a new benefit called Universal Credit. Universal Credit is being introduced in stages. When it affects you will depend on your personal situation, where you live and what benefits you currently claim. As of September 2016 it’s still in Stage 1.
What will I get?
You’ll normally get the assessment rate for 13 weeks after your claim. This is currently:
- Up to £57.90 a week if you’re aged under 25
- Up to £73.10 a week if you’re aged 25 or over
After that, if you’re entitled to ESA, you’ll be placed in one of two groups and will get:
- Up to £102.15 a week if you’re in the work-related activity group
- Up to £109.30 a week if you’re in the support group
These figures were correct in November 2016.
Can I claim ESA?
You may be able to get ESA if your epilepsy (or another illness or health condition) affects your ability to work.
How do I claim ESA?
The quickest way to claim is to call the ESA contact centre on 0800 055 6688. Alternatively you can fill in the ESA claim form (form ESA1) and send it back or take it to your local Jobcentre Plus office. You will need to provide a medical certificate (also known as a fit note) from your doctor saying that you are not fit for work.
What happens once I’ve made a claim?
There are several stages to the ESA claim process. See our diagram of the claim process, or read on to find out more about each stage.
The assessment phase
Once you have made a claim for ESA, you will be paid the assessment rate while your claim is assessed. This usually lasts 13 weeks but can last longer if there are delays. You will need to keep providing medical certificates from your doctor during the assessment phase.
Capability for work questionnaire
During the assessment phase, you will usually be sent a capability for work questionnaire (form ESA50) which asks more detailed questions about your health and ability. If you are sent one, you need to fill it in and return it within 4 weeks. You can find a guide to filling in the ESA50 form on the Citizens Advice website.
Most people who apply for ESA will need to have a face-to-face assessment with a healthcare professional. This is called a work capability assessment. The assessments are carried out by the Health Assessment Advisory Service, usually at one of their centres. If you have to travel to the assessment, you can claim travel expenses. If your disability makes it difficult or impossible to travel to the assessment, you can ask for the assessor to come to your home instead.
You can find the answers to frequently asked questions about the ESA assessment on the Health Assessment Advisory Service website.
The face-to-face assessment has two parts:
- The limited capability for work assessment
- The limited capability for work-related activity assessment
Part 1 - limited capability for work assessment
The aim of this part of the assessment is to decide if you are eligible to claim ESA. The healthcare professional will ask you questions and score you based on your physical and mental abilities. If you score enough points you will be awarded ESA. If you don’t score enough points you’ll need to claim Jobseeker’s Allowance instead.
Part 2 - limited capability for work-related activity assessment
The aim of this part of the assessment is to decide which of 2 groups you will be put into:
- The support group – you get a higher rate of ESA and are not expected to look for work
- The work-related activity group – you get a lower rate of ESA and are expected to start doing things to help you return to work, including attending work-focused interviews
How will I be assessed in the ESA assessment?
During both parts of the assessment you will be asked about your physical and mental abilities. These are divided into ‘activities’ and ‘descriptors’. During the assessment the healthcare professional will be looking at which descriptors best describe your situation.
Limited capability for work assessment
In the first part of the assessment, you score points depending on which descriptors apply to you. You need to score 15 points or more to qualify for ESA.
See the box below for some examples of how the descriptors might apply to someone with epilepsy. You can read a full list of the descriptors in Appendix 1 of the Disability Rights UK factsheet The work capability assessment
Descriptors for the limited capability for work assessment
Part 1: physical abilities
Activity No 9
9 a (i)At least once a month experiences:
Because this activity talks about loss of bladder or bowel control while conscious, it would be difficult to argue in relation to a tonic-clonic seizure.
Activity No 10 Consciousness during waking moments
10 (a)At least once a week, the person has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration 15 points
10 (b)At least once a month, has an involuntary episode of lost or altered consciousness resulting in significantly disrupted awareness or concentration 6 points
If you have seizures where you lose consciousness or your consciousness is altered, descriptor 10(a) or 10(b) may apply to you.
If you score 15 points from any of the activities listed in part one, you should qualify for ESA. You can only score once for each activity.
Part 2: mental abilities
If you score 15 points altogether for activities listed in parts one and two, you should qualify for ESA.
If you don’t score enough points to qualify for ESA, you will need to claim Jobseeker’s Allowance instead, unless you meet one of the exceptional circumstances below.
Even if the decision maker thinks you haven’t passed the limited capability for work assessment, there is one other way you may pass it. This is if you have information from a healthcare professional which says that one of two exceptional circumstances apply to you.
The first exceptional circumstance is about having a life-threatening illness.
If you have been told you are at particular risk of Sudden Unexpected Death in Epilepsy (SUDEP), this may apply to you.
Epilepsy Action has more information on SUDEP
The second exceptional circumstance is written below.
You suffer from some specific disease or bodily or mental disablement and consequently there would be a substantial risk to the mental or physical health of any person if you were found not to have a limited capability for work-related activity. This risk should be linked to work you could realistically do according to your education and skills. This circumstance will not apply to you if the risk could be significantly reduced by making reasonable adjustments to your workplace or by you taking medication as prescribed
If your specialist feels either of these exceptional circumstances applies to you, they will need to write a letter saying this. Make a copy of this letter then, ideally, send it with your application form. If you have already sent your form off, send it in anyway, and take a copy with you to your assessment.
Limited capability for work–related activity assessment
In the second part of the assessment you will be asked more questions about your physical and mental abilities. You can read a full list of the descriptors in Appendix 3 of the Disability Rights UK factsheet The work capability assessment
If any one of the descriptors applies to you, you are automatically placed in the support group. If none of the descriptors apply to you, you will be placed in the work-related activity group.
How should I approach the ESA assessment?
A lot of people understandably get anxious about the ESA assessment. Here are some tips to help you feel as prepared as possible.
Make notes beforehand
Making notes beforehand of the things you think will be most important to say can really help once you are in the assessment. Here is a list of the sorts of things that a person with epilepsy may need to mention. You can use this list to make notes about your situation.
- If there is a particular cause for your epilepsy – for example a brain tumour
- What happens to you during a seizure
- How often you have seizure
- How often you lose control of your bladder or bowel
- What your seizure recovery is like – for example whether you need to go to sleep, or if your awareness is affected
- How long it takes you to recover from a seizure
- Whether you have had to go to hospital because of a seizure
- Whether you have recently been injured during a seizure – for example cut your head
- Whether rescue medicine has been given to you by a carer or health professional after a seizure
- Any support you are given by a partner or carer
- What the side-effects of your medicines are for you
- Whether your memory and/or concentration are affected
- If you have worked in the past, how your epilepsy affected your ability to do the job, and how working affected your epilepsy
- Any other impact your epilepsy may have on your life
- Any relevant information about other health conditions
Take someone with you
As with any important meeting, it can really help to take someone with you. Ideally this will be someone who can help you feel as relaxed as possible. And someone who could remind you to look at your notes if there are things you don’t remember. They could also take notes during the meeting as a record of what was said.
Ask for a recording
You can ask for the ESA assessment to be recorded, by calling the Health Assessment Advisory Service on 0800 288 877. You don’t have a legal right to a recording, but they should consider your request. You should make the request as far in advance as possible.
For more information on recording see the Health Assessment Advisory Service website.
Once the ESA assessment is complete, the assessor will send a report to the Department for Work and Pensions (DWP). The DWP makes the final decision about whether you are entitled to ESA, and if so which group you will be put in. They will send you a letter letting you know the decision.
If you’re not happy with the decision, you can ask the DWP to look at your case again. This is called a mandatory reconsideration. You have one calendar month from the date of your decision letter to request this.
If the DWP has looked at your case again, and you are still unhappy with the decision, you can appeal. For more information on appeals and reconsiderations see the appeals and reconsiderations factsheet on the Disability Rights UK website.
Where can I get help with benefits?
Free online tool to help you prepare for your ESA assessment. The tool allows you to practice answering the sort of questions you’ll be asked in the assessment.
Provides a free online benefits calculator and grants search tool to help you find out what financial help you are entitled to.
Helpline: 0808 8002 2000
Citizens Advice provides advice to everyone on their rights and responsibilities. Check the website or your local phonebook for details of your nearest Citizens Advice service.
Telephone advice in England: 0344 111 444
Telephone advice in Wales: 0344 77 20 20
Find your local Citizens Advice Bureau in Scotland
Find your local Citizens Advice Bureau in Northern Ireland
Disability Information and Advice Line services, run by and for disabled people. They may be able to refer you to someone who can help you fill out claim forms for benefits (provided there is someone in your area).
Helpline: 0808 800 3333 (to find your local group)
This website has lots of information about all the different benefits that are available.
Disability Rights UK
This website has a number of free factsheets you can download. It offers basic information about benefits, tax credits, social care and other disability-related issues for claimants and advisers.
Welfare Rights Unit
Welfare Rights Units give free advice and support on benefits. Some can also help with completing claim forms and appealing benefits decisions. Contact your local council to find out if they have a Welfare Rights Unit. To find your local council visit gov.uk/find-your-local-council
This website has lots of information about the benefits that are available in Northern Ireland.
Offers information, advice, advocacy and representation for people in Northern Ireland.
Helpline: 0800 988 2377
If you would like to see this information with references, visit the Advice and Information references section of our website. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 0808 800 5050.
This information has been produced under the terms of The Information Standard.
- Updated November 2016To be reviewed November 2017